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Pay for performance programmes are being adopted in a growing number of countries as a quality improvement tool. In 2004, the United Kingdom introduced the Quality and Outcomes Framework (QOF) which primarily aimed to improve the management of common chronic conditions, such as diabetes and stroke, in primary care. The Department of Health in England is now considering allowing more flexibility in local pay for performance schemes, such as the introduction of higher payments for meeting tougher performance targets.

Research carried out at Imperial College London suggests that such local pay for performance schemes can improve target achievement by general practices but have no significant impact on the overall quality of clinical care. The study was funded by the NIHR and the NW London Collaboration for Leadership in Applied Health Research and Care (CLAHRC) and published in the journal PLoS One.

In the study, which was carried out by a team from the Department of Public Health and P…

Online access to medical records by patients has the potential to promote patient-centred care and improve patient satisfaction. Online services may also offer patients greater convenience although concerns remain about privacy and confidentiality. However, online access and services may also prove to be an additional burden for healthcare providers who are already under considerable workload pressures.

In a study published in the British Journal General Practice, I and colleagues form other UK universities assessed the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. We carried out a systematic review that focused on all studies about online record access and transactional services in primary care.